Further evidence has emerged that the
introduction of dedicated, consultant-led acute care
surgical centres results in markedly improved patient
outcomes.

Speaking at the 82nd Annual Scientific Congress
(ASC) of the Royal Australasian College of Surgeons, Dr Rose
Shakerian, a General Surgeon at the Royal Melbourne
Hospital, reported that an Emergency General Surgery Service
(EGS) was established at the hospital in 2011, in response
to an increased volume of acute general surgical and trauma
cases.

“The aim of this study was to assess the impact
of the new EGS service on length of stay, and admission to
the ward from the Emergency Department, and to compare these
outcomes with those of the traditional model,” Dr
Shakerian said.

“Using our prospective surgical audit
database, we performed a retrospective review of patients
admitted to the EGS from February 2011 to January 2012 (a 48
week period) and these outcomes were compared with those of
the previous 48 weeks.

“A 73% increase was noted in the
total number of admissions, from 1193 pre-EGS to 2065
patients since the introduction of the EGS service. With the
inclusion of inpatient referrals (411 patients) and Trauma
admissions (2047 patients), the EGS service managed 4523
patients during the study period.

“Hospital length of
stay was reduced from 5 to 4.1 days (18% reduction) and a
20% improvement was noted in the proportion of patients
admitted from the Emergency Department within eight hours
(49% vs 69%). The percentage of surgical cases conducted in
hours was found to be 50%.”

Dr Shakerian concluded that
early and increased consultant input reduced length of stay
and time spent in the Emergency Department, despite the 73%
increase in acute admissions during the introduction of the
new service.

In 2011, the Royal Australasian College of
Surgeons wrote to all health ministers and senior health
department officials in Australia and New Zealand, enclosing
a comprehensive report which demonstrated that the
establishment of dedicated acute care surgical units leads
to greater efficiency and better patient outcomes.

Approximately 1200 surgeons from New Zealand, Australia
and around the world are attending the ASC, which runs from
6 to 10 May and is being held at Auckland’s Skycity/Crowne
Plaza Convention
Centre.

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